Friday, April 13, 2012

Young Doctors Have Bleak Outlook on Future

Most young doctors are pessimistic about the future of U.S. health care, reports Reuters. The finding comes from a survey released by The Physicians Foundation, a nonprofit organization dedicated to helping physicians improve health care for their patients. The foundation questioned 500 doctors 40 years of age and younger. Of those surveyed, 57 percent expressed pessimism about the future of health care, citing health reform, new regulations, and declining payments as the biggest factors contributing to this bleak outlook.

Lou Goodman, PhD, executive vice-president, Texas Medical Association, assured Reuters that many people still want to become doctors and medical school applications remain high. “‘But what we’re seeing is that once they get out [of medical school], it’s not what they expected,’ he said. ‘Young doctors are finding upheaval and transition in the way the healthcare system is structured right now ... And when our doctors are dissatisfied, we’ve got a problem with the system.’”

Many doctors say the changes happening in health care today do not put patients first. Below are some reasons why young physicians say they are pessimistic:

“(I) Don’t trust government to do the right thing for patients and physicians or to enact lasting improvements.”

“... The changes that are being made are not made with the patient in mind, but with the ‘bottom line’ economically in mind. Not once is the patient mentioned in all these changes.”

4 comments
:

I am a third year medical student and I feel that most of my peers are generally quite optimistic about their future in medicine. Most medical students at my stage in training have anxiety about residency training and the NRMP match that is fast approaching in < 12 months. Still, most of us feel like the future will be bright as long as we get a training program in the field of our choice.

Medical students today are very aware of the pressures put on primary care providers in the fields of family medicine, general internal medicine, and pediatrics. Out of a class of 240 students there is surprisingly little interest in primary care specialties, which is a big problem for a state the size of Texas. Most of my classmates want to go into sub specialties or pursue fellowships in medicine or surgery that will lead to higher reimbursements, less pressure to see a huge volume of patients, and more time for a balanced family life. Students who still want a career in primary care despite the circumstances do so knowing that they may eventually have to see a large volume of patients in a day to keep up with specialist colleagues that do procedures. For these students, the future may seem bleak, and they may feel pushed toward procedures themselves despite their passion for primary care.

I believe that CMS needs to evaluate how it reimburses for procedures v. clinic visits so that students fret less about their financial future and pick specialties based on genuine interest. I believe this would remove a lot of the pressure from the match process, would lead to greater long term physician job satisfaction, and would lead to a greater supply of primary care practitioners for Texas.

The journey to becoming a physician is simply becoming too prohibitive. To find young individuals who wish to live at the poverty line and spend their prime decade of life being overworked and underpaid is one thing. To find individuals who are willing to do so only to come out the other side to a job that will not support their practices, families or pay their loans should warrant a thorough psychiatric evaluation. We continue to push young people to become primary care physicians while at the same time cutting funding and incentives to do so. The numbers are published, and it doesn't line up. The system is skewed towards specialization and sub-specialization and until that changes, we will forever be at a lack of PCPs. As if things weren't discouraging enough, our government decides to cut subsidized loans for professional school students in order to fund undergraduate grants and loans. Can anyone explain the logic here? We increase the debt of some of the most indebted in the nation and use their misfortune to educate younger Americans like themselves? Medical school applicants continue to rise, but I would argue that is a product of a general lack of understanding and further contributes to the discontentment this study uncovers as they become young doctors. Altogether, we have to begin to alleviate these barriers if we desire to meet the health needs of our state and our nation in the future. Physicians are certainly altruistic, but they are still very much human and smart enough to see when the train is headed off track.

I realize now I am nothing more than a mid-level manager of a health care team... between the paperwork and the amount of minutes I am actually given to spend with a patient it's obvious that the people who really care for patients are the nurses. I just sit in a room making the decisions... I don't even get to make them actually, I just get to hope an attending is listening when I talk. In fact, get in trouble for going the extra mile. I get ignored when I bring up evidence based arguments for my point of view. I am an intern resident physician, and I hate my life. I have my "dream job" and it's a nightmare.

I talk to alot of doctors who were frustrated with the "system" and just wanted to help their patients. They decided to stay in the healthcare industry but pursue it from an entrepreneurial standpoint and are now independent health coaches for a program called "Take Shape for Life". They feel they are truly making a difference with their patients here than they ever did working in a hospital or private practice. By setting their own hours they have regained their family life back again as well. Others who wish to stay with their practices utilize the program with their patients and feel good again about what they are accomplishing. Justsignmeup.tsfl.com

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